Wherein a surgeon tells some stories, shares some thoughts, and occasionally shoots off his mouth. Like a surgeon.

Sunday, February 17, 2008

Sad Times

[This post is another of my forewarned weekend rants, written in part a while ago, during my outage.]

The New York Times recently ran an article that hits home. For a variety of reasons, I've been feeling pretty depressed; if you put my mood on a pie-chart, the state of our nation and world occupies a large part of the dark areas. The rest, well, it's just who I am, and not worth sharing.

If anything, the article doesn't plumb deeply enough. The world IS depressing; and to the extent that some people don't see it that way, well, that's depressing, too. Where to start? OK, how about the war in Iraq?

I accept that some don't see it as the worst mistake ever made by a US president since the beginning of the Republic. It most certainly was, but that not everyone agrees isn't what disturbs me. What does, is that the argument for ending the war is characterized by all the Republican candidates as "surrender," as a great victory for al Queda. But it seems so obvious: our being there in the first place is an enormous victory for AQ. If you were a bunch of guys living in a cave, who had no army, no means on their own to take down this country, wouldn't it be perfect to sucker us into an endless war, depleting our military, our treasure, and our standing in the world, while providing them with a steady stream of recruits? In order to avoid "waving the white flag," as McCain et al like to put it, we must keep doing exactly what those cave-dwellers want: stay there forever, bleeding ourselves to death, and blatantly disregarding everything we've always stood for; not to mention ignoring the things that really might make us safer. On their own, terrorists could hurt but have no means to destroy us, yet it seems they inveigled us very possibly to have done it to ourselves. I'm not arguing that we have no obligation to the Iraqis whose country we so carelessly invaded, nor that leaving wouldn't potentially lead to big trouble within Iraq and beyond. I'm just saying that Bush's war is a win-win for al Queda, and a lose-lose for us. To frame the argument as "white flag" versus "love America" is depressing political bullshit. And stupidity. In his culminating project, ending his string of flip-flops du jour, Romney said, in effect, that voting for a Democrat is "surrendering to terror." How venal is that? How completely despicable!

"Stay on offense." "Strong on terror." What the hell does that mean? Invade another few countries? Of course we need to be intensely vigilant and to intervene when it makes sense. That requires the gathering intelligence; doing so, among other things, depends on having friends around the world who'll help provide it. Which is why it's so important to be respected and admired, rather than hated. Or laughed at. Mitt wanted to "double Guantanamo." If we are so insecure about the ability of democracy and our Constitution to deal with such an enemy, then what the hell are we doing trying to export such a system to the rest of the world?

It's depressing to hear the Republican candidates promise to be like George Bush only more so. McCain: more war, lower taxes. Giuliani wanted even bigger tax cuts. At their debates, they elbowed each other out of the way to exhume the corpse of Ronald Reagan. How many examples do we need before we agree that Reaganomics doesn't work? Reagan instituted tax cuts, everyone felt great, while the deficits mushroomed. It doomed George's dad, who followed him. Clinton raised taxes, Tom Delay and Newt Gingrich screamed, but it brought the budget into balance, the economy roared back; then Bush cut taxes, the Republicans felt great, the deficit once again skyrocketed, and the economy is crashing like the house of cards that it obviously was. And yet... all we hear from the right is a return to Reagan (who also, by the way, reversed all of Carter's initiatives to reduce oil consumption -- and look where that's gotten us.)

"George Bush has kept us safe." Reminds me of the guy falling off the Empire State Building who says, as he passes the thirtieth floor, "So far, so good." The things that HAVE kept us safe, any president would have done: airport security (anyone remember what a fiasco it was at first, because of Bush's insistence -- or was it Cheney's? -- that it be privatized); surveillance (any reason why it couldn't have been done legally; change the law if needed?) The centerpiece, the central front -- ie, Iraq -- has by no reality-based measure made us safer. The opposite is undeniably true. And the list of remaining needs is long.

Some things seem so obvious that they ought to transcend politics. Why is it only Republicans who deny global warming? Why do the people who believe Earth is six thousand years old (or is it twelve?), who want evolution out of school curricula and creationism in, come from the right wing? As the current government overtly tries to redact and ignore science, why isn't everyone screaming bloody murder?!!

How can anyone argue that the institution of marriage is threatened if people of the same sex who love each other have access to it? If your religion doesn't allow it, fine. No church ought to perform marriages of which it doesn't approve. But why prevent another from doing it? Why amend the Constitution? Where's the harm? I've been married thirty-six years. I feel not the slightest threat to my marriage if gays join together in love. Moreover, it's clear that sexual preference is for the most part genetically determined. Like claiming the age of the Earth is a few thousand years, arguing that homosexuality is some sort of abomination in the eyes of God is to ignore fact; at the very least, he has seen to it that there are gays in every culture, in every religion, in every age of man. If it's a perversion, who's the pervert? Clearly the fear-based need to cleave to certain beliefs trumps common sense and common decency.

Democrats, the hollerers spew, "blame America first." What crap!! There are those of us who know the transformative power this country can and has shown, who have seen its greatness, and who long for its return. To lament the last seven years is not to hate America, but to pine for lost love. I was in college when JFK was president; only two weeks before his assassination he spoke at my college, and I was there. His vision and his rhetoric, his wit and intelligence -- even his good looks -- were, to a young person like me (idealist, maybe, but not naive), inspiring and energizing. I hear echoes. But not from the right. From them (from their candidates and radio and TV hosts at least), I hear the peddling of fear, of divisiveness, of exclusion. To the extent that there's hope of harnessing the power of the diverse opinions and skills in this country and bringing it again to greatness of the positive kind, that hope resides not Rovian divide-and-conquer politics, but in imagining much more. From another website: "The reason Obama is winning and will win is so simple. Americans want to believe in themselves again." I think it's true for more than Democrats. But is it possible?

As a veteran, I find it depressing that for most Americans, "support our troops" seems to mean sticking a magnet on the back of their vehicle (well, I admit I have one: but it's this); that patriotism is defined only by loving the war in Iraq. When I was in Vietnam, my wife was working for George McGovern, and I felt supported as hell. How many nowadays would park their yellow-ribboned gas-guzzling SUV and agree to a tax surcharge to pay for the war and its long-lingering needs for our vets? Show of hands?

Ever since Ronald Reagan declared the US was once again "walking tall" after we (wow, successfully!!) invaded that super-power known as Grenada, keeping the world safe for people who couldn't get into American medical schools, there are some that are only proud of this country when it's "kicking ass." That form of patriotism is good for selling flags and ribbons and bumper stickers, but for not much else. The people who would label me an America-hater and an infidel want to believe in fantasy, to live on borrowed money, to let another generation deal with the mess our politicians (and those who elected them) have made. Unfortunately, they may well have been successful to the point of no return. I'd like to think Barack Obama is right, that there is hope. In the thirst to be proud of this county again, and to be inspired one more time before senescence, I'm willing to risk disappointment. But I think it's too late. We're screwed, and we've done it to ourselves; by succumbing to fear and superstition, by twice electing a president who clearly does not believe in what has, until recently, made our country great. Respect: given and received. Laws: made and followed. Discourse: valued and encouraged. Reason: sought and produced. Power: respected and reserved.

Other than that, I'm feeling pretty good. And believe it or not, I edited a lot of stuff out before I posted this.

50 comments:

Sid, it's your blog, and you can do what you want with it, but any more of this stuff will lose you your audience, and the profession of surgery will be the worse for it.

Gruntdoc said it best (Feb 10):

I am very tired of reading political diatribes on otherwise worthy medical blogs. If you’re going to do them, please tell us in big letters that a) it’s political, not medical, therefore out of your area of specialized knowledge and just a muddled recapitulation of what others of your particular political bent have already said (and have said better), and b) tell us if you’re kidding. The one I read tonight I had to read twice it was so bad. I was sure it was a joke. Apparently not, which is a pity. Do us all a favor and just comment in the forums at your favorite “me, too” political place. That’s what I do, as a service to you, my dear readers. Nobody comes here to see what I think about any politics outside medicine, and I respect all my readers enough to not insult the half who won’t agree with me if I did. Oh, and my presidential endorsement remains.

Sid, I was going to remark about how you write so many words without swearing! I can't get past the first paragraph, usually. But then I read your friend JB's comment.

Dear Gruntdoc, who/whereever you are: Sid's right and you are an ostrich. :P Heh, now that the obligatory name-calling is out of the way, the name-dropping. In spite of your pseudononymous Gruntings, Howard Zinn actually said it best, "Civil disobedience is not our problem. Our problem is civil obedience. Our problem is that numbers of people all over the world have obeyed the dictates of the leaders of their government and have gone to war, and millions have been killed because of this obedience. . . Our problem is that people are obedient all over the world in the face of poverty and starvation and stupidity, and war, and cruelty"

So, JB, go ahead and turn off Sid's channel and enjoy your gated-and-blinkered community while it lasts. Those of us stuck in the real world have a tendency to think, and speak, outside *your* area of specialized knowledge and that clearly makes you uncomfortable. Just one of many projects we're not qualified to write about is called democracy. We'd like to actually try it out sometime. If that's okay with you.

Well, jb, other than the fact that it's small letters and not big ones, I did exactly what you said. The post begins with such a warning, and was preceded last week by an explanation and a plan to post these rants on weekends. I don't much care if I lose readers -- although I'd think most are able to separate one type of post from another. I don't see why it must be so that only talking heads, or typing fingers, of the overtly political sort can be allowed to express opinions, especially in these times of such truly existential import. I don't care what medbloggers think about football teams, but many of them post on that.

I don't blog for money; there will always (until I run out) be posts on surgical matters, and the older ones get regular read by people searching for useful information. I've appreciated your comment in the past, and I hope you'll come back in the future. Rants such as these will always be so labeled. No need to read further when you see the warning. It'll probably be better for your general health.

jb: I don't buy it. I just wrote a long, long comment about what the fuck you might mean by "the profession of surgery will be the worse for it," but my cooler head prevailed I deleted it. I'll just say I disagree, and I don't think your prediction will bear out.

I certainly don't expect these posts to be non-controversial, and I understand jb's point of view, though I don't agree. I'd be honored if there's lively conversation here, and most hopeful that it will remain as civil as it seems so far, mostly.

Hey, just sticking my head in to say, "Sorry about the F word, jb." It adds a bunch of malice that you don't need.

Also, Sid: The effect on your readership is an empirical question: you once said that your traffic dips on weekends, and picks up on weekdays. This reader (and weekend warrior? maybe that's the name of your weekend column!) would be curious to know if, after a month or so, the traffic flow changes . . . ?

I think you have some excellent points, and I found your entry thought-provoking. I read it to my husband and at the end he said, "Smart guy. He sounds like an engineer."

I told him you were a surgeon, and he said, "Yeah. Same thing, only the parts are floppier." Then he thought about it for a minute and said, "He probably wouldn't be amused by that, but it's a compliment."

Dr Sid, I especially like this: "made our country great. Respect: given and received. Laws: made and followed. Discourse: valued and encouraged. Reason: sought and produced. Power: respected and reserved."

I like Obama as an orator. I might even like him as a person if I got to meet him. But I worry about the "univeral healthcare" that the democrats purpose. I happen to believe in personal responsibility. I think we have a personal responsibility to do our personal best to be healthy. We doctors are there to help our patients do that. But I don't think the government should be my employer.

That said, I would join the armed services to provide care to the soldiers and their families (not sure they would take a 50 yo). My husband would not be happy with that decision. I will not "accept" Tri-care or Medicare or Medicaid. The reasons would take too much space. I will take care of them on an individual basis.

Keep writing Dr Sid, no matter the subject. I'll stop by and read. And like a few of your other readers, I hope to meet you in person some day.

I, for one, deeply appreciate the honest and deep reflection of these weekend posts (and the prior 'political' posts in the past about the Iraq war). Please keep them up. You are more articulate than I could ever be--and you spark good, thoughtful discussion here that helps us all, regardless of political persuasion, come to better positions.

rlbates: If insurance companies didn't have outrageous standards of who and who cannot have health insurance, and ludicrous costs for employers, I would agree with you that people need to take their own responsibility for their health.Unfortunately, health care is not accessible to everyone. Many corporations don't offer health insurance to the lower employees, and if those people have a pre-existing medical condition, they are out of luck. It's simply unethical and there needs to be a change. I think we as a nation, as well as our "Politicians" need to look at the options, and have serious discussions to find a rational and practical way for everyone to have health care. These are not easy times for sure, but we need to stop watching the talking heads discuss these issues, and start taking these matters into our own hands, and community.

Dr. Schwab,What a wonderfully insightful and thought-provoking post, you should be proud (I say that knowing how important it is for brain health to live in expanded thought). I heard Barack Obama say this morning that what he must first do is INSPIRE a nation, then he can work on doing the right things. I believe he's right, and for me, its such a wonderful thing to trust my belief in him, to feel like my family and I can rest in safety if he is our president. As a country, we must know what it means to feel inspired...inspired as in Lincoln or Kennedy inspired. By contrast I listened to Romney's speech as he withdrew his candidacy and I felt that he was inciting (the impatience of) fear...The difference is quite clear. One candidate will offer fear, the other candidate will offer (the patience of) hope.

Since this is a ranting weekend. Can someone answer questions on universal healthcare?!! I'm an independent in Ohio with my ballot in hand not knowing who to vote for!! I don't think any of them know what to do with the war. I don't just blame the Bush adminstration as Congress helped. I remember in grade school that our government was set up with checks and balances. So, I don't think the Democrats have any better answers then the Republicans. I do know that Obama did not join the cause, but something tells me not to trust him. I don't know what it is but it comes from the gut. Then Oprah endorsed him and that totally turned me off Obama. Then there is Hilliary...she seems to always be on a power trip and she has to many scandals that have surrounded her. McCain... no personality do I say more. Huckabee is the guy I would have a conversation over dinner with, but to religious for my vote. Yes, I'm a Christian, go figure.

Back to universal health care... "a guarantee of health care does not guarantee quality health care." That is a theme I've heard over as I have researched this issue. I've looked at other countries with unviversal health care who appreared to have many problems... quality of care, death rate increased, waiting list?. So, can you professionals discuss this as I don't believe the politicians. They usually just tell you what you want to hear. I do think something has to change, but I'm not one to rush out buy something because everyone tells me to do so. I would appreciate the people in the line of fire giving me their input. I think you guys can give me better information.

Sid, it is your blog, so whatever you want. If something has a problem with it they either get over it or go on. You did give a disclaimer at the beginning.

mamabee: tell your husband he's wrong. I love that comment. I'll have to use it myself!

anonymous 11:28. It's a good and important question. I just hope this comment thread doesn't go off in that direction, because I'm enjoying the comments on the subject(s) of this post. Good and bad. It's a huge subject, is universal healthcare. I put in my two cents here and here, a while back, and there are extensive comments from professionals in them. I'm in a minority of docs on that subject.

ramona: I have reservations, too; in part it's because all the plans continue to use insurance companies which suck away so many healthcare dollars. Nor do I kid myself about costs, problems, etc. But, when people don't take responsibility and don't have coverage, we end up paying for it anyway, just less directly. I also think it's a pretty sure bet that whatever legislation happens, if it happens at all, will look nothing like any current candidate's plan.

sid, you will never lose me as an avid reader of your work. please continue with your 'controversial political commentaries'.

in our small neck of the woods, we were attacked by a superpower. ok it was 1899, but, deep in our psyche we distrust big brothers coming with guns to 'liberate' us from our 'backward' ideas.

we also jokingly say that the americans have their president because they deserve him. let's face it, you guys are the laughing stock of the thinking world. why vote him in again???? sid is right when he says that you need to restore your reputation on the world stage.

but i speak from the perspective of a small nation that has never been a world player (except when we held the super power of the day at bay for three years), so, except for my excitement at the voice of reason that is sid's, please ignore all the rest of my ramblings

lynn: you've picked up the meme coming from the right: that Obama is only talk. If you take the time to go to his website, you'll see policy in detail that is quite more than McCain. And I think you missed the point: he says that in order to accomplish real changes in how the US does political business, there needs to be a strong level of support from the electorate. If he gets it, he'll be able to do some of the things he talks about, but it'll take a groundswell to overcome the entrenched legislators who pander only to their party's base with no willingness to find ways to solve problems. Their goal is re-election only; but if people -- meaning rational people from both sides of the aisle -- make it clear that they won't get re-elected if they keep behaving like that, then things might actually happen for the greater good. Open your mind to the possibility, at least; who knows, some day I might even reconsider Reiki!

I got an email from a reader who tried to post but for some reason, was unable. At his request, I post his comment for him:

Sid -

It needs to be said, not just on political blogs but on all blogs written by intelligent writers such as yourself.

I look forward to your weekend rants.

I think that what the Republicans have been doing to this country is the obscenity. They know the words of morality but are blind to the deeds. They have been busy writing garbage laws to make "In God We Trust" more prominent on our money while ignoring the corruption of the "rebuilding of Iraq" by money-grubbing contractors who don't even want to hire Iraqis to do the work.

That's the obscenity.

The healthcare system in the United States is an obscenity; health insurance is a "perk" for most companies while those who work for smaller companies are left to fend for themselves. They avoid going to the doctor when signs of illness first show themselves because they can't afford to go until their only option which remains is the ER. In the meantime, without treatment, viruses flow through the air to the rest of us.

That's an obscenity.

Republicans in Minnesota are defending their senator by attacking Al Franken for his "nastiness." I call Al Franken "blunt." We need Al Franken and others like him in the Senate no matter who the President turns out to be - Senators who are unafraid to use a four-letter word occasionally when faced with corruption and real-world obscenities.

jb can safely ignore these rants if he wants. I'll keep reading them. And I am not even a surgeon.

Sid-It seemed I touched a nerve with my Grundoc quote. Good.My concern is that you are a gifted surgeon, and a gifted writer. When you write about surgery, you make my life easier, and better, because you teach me about my craft, and you teach civilians about it also, in a way that I wish that I could. For that I thank you, and admire you, and fervently hope that you continue.When you stray into politics, you are doing something that you have every right to do, as I stated in my earlier post. For what may be selfish reason, I wish that you wouldn't. You are getting into an area where your expertise, however well validated by other posters, is minimal. While it may get you a short term warm feeling due to the "attaboys" from people who agree with you, it damages your credibility among many who, unlike me, may incorrectly assume that your veracity in things surgical parallels your expertise in political matters.You have accepted the NY Times version of reality- military stretched beyond capacity, destroyed economy, the whole ChimpyCheneyBushHalliburton end of the world as we know it. From my perspective, when a bunch of folks proclaim that they want to destroy us, I'm happy to take it to them. It hasn't been done perfectly, but it has been done damn well, liberating two nations out of totalitarianism in the process. Our losses and costs, while high, have been lower than any other similar activity in the history of the world. If you don't shudder when you read the rantings of the anti-American and anti-Semitic trash that comes out of the enemy, it's because, like many of the people on the hard left, you believe that history began last week. It didn't. It didn't even begin in the 1930s, but that is a good place to start. They want to do the same thing to us. Don't let the cave dwellers fool you. The only reason that some of them are in the caves is that the US military keeps them there. They have other plans for us. Never again.

jb: well, look how easy it was to express your opinion, and well. Sorta like me. I don't buy the "credibility" issue: if people distrust my surgical posts because I'm a liberal, well, that would be strange indeed.

As to the stretched military, it's the generals who say so, including the current chairman of the Joint Chiefs. As to cost: in today's dollars, only WWII was higher, per several charts I've seen. As to our standing in the world (I realize some don't care, but I think it's crucial) you only have to listen to other world leaders, international polls, etc. And it ain't just the NYT that says the economy is in rough shape: surely you agree with that.

I was wholly in favor of the Afganistan war, and horrified when we left it half done to go where there was no threat. The "liberation" was the easy part. The havoc wreaked will require generations to fix. And the idea that we're just running up debt to pay for the war is a disaster in the making . Made.

The cave-dwellers haven't fooled me: I realize the threat. They fooled George Bush, by getting him to take his eye off the ball and getting tied up forever in a way that only helps them. And they were living in caves long before the US military showed up. They are, evidently, totally safe there.

Expertise? None, I suppose, other than being a very engaged voter who reads politics voraciously, from many points of view. Books, magazines, newspapers, internet. You didn't touch any of my nerves, nor in any way offended me: I'm happy to have the discussion, even if I don't change any minds.

My grandfather's chief of staff from his US Senate days, at Grandpa's funeral, quoted what the chief of staff of another Senator had said to him: "You're lucky: you always know how your guy is going to vote. By his conscience. My guy hides in the closet till he sees how things are swinging so that he'll always vote on the winning side." (My grandfather was a Republican who voted for the Civil Rights Voting Act of 1964, with conviction that it was the right thing to do, and was widely denounced for it at the time in his party. History has a way of clearing the view over time...)

I've thought of that staffer's quote many times of late. Obama was willing to vote his conscience and vote against expanding the war to Iraq, voting by what he felt was right, no matter what it appeared at the time that it might cost him personally.

Another excellent post. I don't get jb's comments about how this somehow diminishes your medical postings. One of the reasons I keep coming back is because you speak on things other than just medical. You are insightful, well thought, and to piggyback on Graham, I appreciate your gay supportive views (which have little to do with you being a surgeon). jb, perhaps a less myopic view of your own would expand your own horizons. I don't think you'll bw losing your audience. Thank you for your thoughts, your words, and for being the man of your convictions that you are, and for saying it like it is.

alison: how impressive to have a grandfather who was a US Senator, especially in that era, and willing to vote for the voting rights act. My brother was Senate page, in about 1960, for Richard Neuberger, a moderate Democrat from Oregon. Maybe he knew your grandfather. In those times, as you know, there was actual collegiality among them all, and members of both parties who worked in cooperation with each other: Javits, Dirksen, Goldwater, Neuberger; nearly all of them, really. Could it happen again? One can hope. But probably not.

I think there is something fundamentally wrong with the "leave it to the experts" model of social discourse: it is undemocratic.

I bristled this morning because I perceived (correctly or not) the suggestion that surgery might be better off if it stayed out of politics.

Well, maybe that's true as far as it goes. I guess I don't know.

But whatever the effect on surgery, all of us will surely be worse off if surgeons stay out of politics. Surgeons, like university professors, judges, lawyers, etc., represent the minds of our culture. It is as senseless to pigeonhole them into their profession as it would be to refuse to use the fire extinguisher in the hall because the fire is in the kitchen. (Okay, sloppy metaphor. Sorry.) The point is that asking surgeons to check their tongue on politics is a a waste of intellectual energy that is likely to hurt all of us in the long run.

I grew up in rural Idaho, where poor rural voters turned out for Bush in droves. They have no clue that his policies are part of the reason they hurt so much. And they are not likely to come around on their own -- someone has to show 'em. Now, who is that going to be if everyone keeps their nose in their work?

I politely submit that talking politics and taking an, ethical, human line like Dr. Schwab has done here is the most professional thing a person can do. Workers in the trades go to work for a wage, and leave their work behind them at 5:00 PM. The professions link their work to the greater well being of a the community as a whole. I know that sounds like hokey BS, but that is the fundamental distinction between, say practicing medicine and selling Band-Aids, or practicing law and filing motions, or teaching and instructing. It is the distinction between a profession and a trade. It would be a far greater disservice to the profession of surgery if Dr. Schwab or any other surgeon were to reduce it to a trade by declining to mix his life with his work.

The suggestion that Dr. Schwab may do a disservice to his profession when he mixers his medicine and politics has it backwards. Dr. Schwab is only a professional in the true sense to the degree he does precisely that.

That's just my humble, young, ill advised and likely idealistic two cents. But I don't WANT to get my political advice from the experts or the pundits or the informed sources. Or, at least I don't want to get all of it there. I also want -- need, even -- to hear someone say, "last time I saw this happen was . . . " or, "This reminds me of when . . ." or, "I've been bothered by this for 30 years, and here is why . . ." or whatever. I don't think I am unusual in that respect.

FWIW, my interpretation of jb's "surgery will be the worse for it" comment was actually complimentary: he was, I think, saying that it would be too bad if I lost readership because the surgery aspects of the blog are good for the profession. But maybe not.

Thanks for sending me your previous posts. I had no intentions of sending the thread into the wrong direction. I've been reading/researching since I put the kids to bed. I feel like I have some better answers. I still have a couple of weeks to go over all the information.

Sorry that you had a "depressing mood" but hope that you see the beauty within our country. My hometown, Allen Co. KY lost 4 people to the recent tornadoes. Macon Co. Tn (13 died, 300 homes destroyed) is just across the line or as we say "spitting distance". (no hillbilly jokes!!) The land, homes, livestock, are gone but not the spirit of the community. No politician brought that out. It was the people who brought hope to those who had none. Put that in your pocket to brighten your tomorrow.

Sid, your interpretation of my comment regarding your possible audience loss is 100% correct. Like it or not, this country is pretty evenly divided on its view of Bush as either the worse president ever, or one whom history will treat a lot more kindly than present day comments suggest (if you don't think that's possible, check out what was said about Harry Truman when he was president). I'm in the latter group- I think that a lot of things that Pres. Bush has done were bad, but I think overall he will prove to be a force for good, and I shudder to think where we would be today if Gore, Kerry, or Clinton (any Clinton) were in the Oval Office today. My opinion. Some of your correspondents will think I'm an idiot and skip over this and any of my future posts. Not a problem. It is a problem, in my view, if some of your readers think that you are a Code Pink/Cindy Sheehan/Michael Moore type nutjob because of your political posts, and skip over your terrific surgery writings.

Sid Wrote: If you were a bunch of guys living in a cave, who had no army, no means on their own to take down this country, wouldn't it be perfect to sucker us into an endless war, depleting our military, our treasure, and our standing in the world, while providing them with a steady stream of recruits?

That's exactly how they brought down Russia or have we already forgotten the Russian-Afghan war that was covertly funded by America. Sure it led to what now seems to be the temporary downfall of Communism but it also put the Taliban in power in Afghanistan.

Sadly America is responsible for it's current place in Global politics and for creating many more of the same terrorists we want so desperately to fight. It's going to take a lot of work to fix it.

PS it's your blog, write what you want. Although I don't think you need to see those words from me.

jb: thanks. I don't think I'll live long enough to witness the judgment of history; but it seems impossible that a president who ran up trillions of dollars of debt and left it for the next generations, and who embarked on a war for a variety of ever-changing reasons that upset the balance of power in the Middle East in favor of Iran and Syria will be regarded favorably. If things eventually work out over there it will be in spite of, not because of the misadventure. It'd be like giving credit to a person who started a forest fire that led to better fire control, after burning a million acres. But I've appreciated your comments. It's a weird and discouraging world.

I realise that much has already been said on this, but isn't politics and government supposed to be of the people, by the people, for the people?

I'm pretty sure the root origin of the word lies with the Greek for citizen, much as Policeman, and Metropolis. As such, isn't everyone's view not just valid, but a form of expert opinion?

Or am I being too British? (See Bongi's comment)

"Politicks is the science of good sense, applied to public affairs, and, as those are forever changing, what is wisdom to-day would be folly and perhaps, ruin to-morrow. Politicks is not a science so properly as a business. It cannot have fixed principles, from which a wise man would never swerve, unless the inconstancy of men's view of interest and the capriciousness of the tempers could be fixed." [Fisher Ames (1758–1808)]

Open your mind to the possibility, at least; who knows, some day I might even reconsider Reiki!

Good one, Sid. Actually, I'm not a McCain fan, either. I don't consider myself a Republican, but rather, a conservative. To date, no one floats my boat other than Newt (waiting for tossed snowballs to fling my way). I can't go with any of the Democrats because they aren't conservative. They want to help themselves to more of my hard-earned money in all their entitlement programs.

As for Iraq, I believed in the war in the beginning because I used to live there, and in Iran, and in Saudi Arabia. Anyone who believes Saddam didn't spirit his weaponry to Syria isn't facing reality. They have/had every intention of blasting us off the earth. Same goes for Iran.

We knew this was going to be a long war, but I don't think Bushy has done right with his decisions. And, he's no conservative.

Now, as for the Reiki, y'all come on down and let me melt your synapses sometime.

Lynn: Newt is a bright and witty and thoughtful guy who very often says things worth thinking about. Were it not for the fact that he is perhaps the single person most associated with the beginning of the "the other side is evil and deserves nothing but derision" brand of politics now so prevalent, I might even consider him a worthy person. But he is. So I don't.

Remember that John Kennedy upped the ante in Viet Nam, right after the Bay of Pigs failure. I remember vividly his going on TV and apologizing for the B. of P., taking full responsibility. With his untimely death he escaped responsibility for Viet Nam.

Thank you Dr. Schwab for writing so eloquently what I've been feeling for so long. Don't listen to the naysayers, for we all have a duty as Americans to become involved in the governing of our country - even if that's just by posting insightful and heartfelt political "diatribes" on a medical blog :-)

This post made me cry - everything makes me cry, so don't take it personally - but it so wonderful to see an American being passionate about these things that seem so important to me. I won't have a vote in the US election but what happens will affect everyone everywhere and it is heartening to see an American voter who cares so much about things that I believe in also.

I am a medical professional; I enjoy your blog. I disagree with most of your political writing.

It is called the War on Terror simply because of political correctness (an invention of the Left) It is a war on jihadists/radical islam.

That is the group that attacked us and has been responsible for most of the global terrorism within the past 40years.

I voted for Bush 43 twice; I am very disappointed in his performance but that being said given the choice I'd rather have him as POTUS in a time of war than any of the alternatives.

I view the conflict in Iraq as a spark that will bring change and force radical Islam into the 21st century. We freed a quarter of a billion men, women and children from two tyrannical regimes (Afganisthan and Iraq)the nationbuilding process in both those countries will take years but will bear fruit.

This war will be won on resolve; it will take leaders with same. I'm sorry but I don't see that in Pelosi, Reid, Obama, Clinton, etc.

anonymous: I'm glad you like the other stuff. I think it's called the War on Terror (it seems we agree on the stupidity of the name) because Bush wanted a convenient meme by which to anoint himself a self-proclaimed "war president," and as a convenient way to keep us always scared, and to convince people -- you included -- that we need someone like him to keep us safe. It's a war, but not one that will be won with armies. The people whom you dismiss understand much better than he, in my opinion, what it will in fact require to win, and they take the task as seriously as anyone; they just have a clearer eye on what's needed. The war in Iraq -- need I say it again? -- has done exactly the opposite of helping to win that war. Your long-term view is, at this point, the only optimistic one that's left, and I hope it's true. But we'd have gotten then more quickly and in a less devastating way, had we not blundered into the invasion. We may, eventually, be able to put the fire out and to restore and improve the area. Better, however, not to have lit the fire in the first place.

Well this will be a weird comment in that I haven't read the post and ever so briefly skimmed the 1st few comments.

I am really behind in my blog reading/commenting as my dsl was knocked out by an ice storm and it took 6 days to get the replacement part and now I am personally distracted.

As I said...we are at opposite ends of the spectrum and even though I don't agree with some things, I still read.

I like you as a person...which comes through in your writing and further evidenced in your congenial manner while interviewed by Dr A.

I love your writing and would never stay away because I disagreed with something.

I can also appreciate that some people might stay away because of the intense feeling of having their blood boil and so I do think it is a good idea to warn them if they were seeking only medical posts. :)

To that I would say turn the channel but come back on another day or you will miss good the stuff you came here for in the first place.

How does it go? Sometimes great minds have to agree to disagree. And as long as people are civil...we can all learn from one another.

About Me

Boring, Unoriginal, but Important Disclaimer:

What I say here is as true as I can make it, based on my experience as a surgeon. Still, in no way is it intended as specific medical advice for any condition. For that, you need to consult your own doctors, who actually know you. I hope you'll find things of interest and amusement here; maybe useful information. But please, please, PLEASE understand: this blog ought not be used in any way to provide the reader with ideas about diagnosis or treatment of any symptoms or disease. Also, as you'd expect, when I describe patients, I've changed many personal details: age, sex, occupation -- enough to make them into no one you might actually know. Thanks, and enjoy the blog.